Provider Demographics
NPI:1639877095
Name:PROMISE COMFORT CARE LLC
Entity Type:Organization
Organization Name:PROMISE COMFORT CARE LLC
Other - Org Name:CHOSEN ANGELS FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FATU
Authorized Official - Middle Name:KOFA
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-918-0799
Mailing Address - Street 1:829 ADMIRALS QUAY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2766
Mailing Address - Country:US
Mailing Address - Phone:267-918-0799
Mailing Address - Fax:717-791-2494
Practice Address - Street 1:829 ADMIRALS QUAY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2766
Practice Address - Country:US
Practice Address - Phone:267-918-0799
Practice Address - Fax:717-791-2494
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMISE COMFORT CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-15
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA70483601Medicaid